Joint replacement surgery is a medical procedure to replace a patient's degenerated or injured joint with artificial implants. With the advancements in new tools and techniques, the joint replacement procedures have become quite successful in terms of patient satisfaction and implant survival rates. Generally, research has shown that the success of the joint replacement procedure is highly dependent on the final position of the implant. To ensure accurate placement of the implant for an individual patient, robotic and computer-assisted technology have become invaluable tools.
As the mechanical, electrical and computer components of typical robotic systems decrease in size, a new era of robotic hand-held surgical instruments are being developed. With what used to require large robotic systems to create accurate bone cuts can now be accomplished with hand-held systems. For example, the NavioPFS™ Robotic Resurfacing System (Blue Belt Technologies) is a tracked hand-held device that aids a user in performing unicondylar knee replacement. Generally, each system has components programmed to articulate a saw, burr, or cutter to create bone cuts to receive an implant as desired by the user.
Hand-held surgical instruments are normally tracked in space relative to the operative bone to visually show (by way of a monitor) how and where to position or orient the instrument to execute a surgical plan. To create the bone cuts, the user may have to re-orient the instrument such that it is in an operable workspace or along a desired cut plane. For the most part, the user's wrist carries the burden of maintaining and guiding the general position and orientation of the surgical instrument during the procedure. However, the human wrist joint can rotate in three degrees of freedom, which can make it difficult to maintain the device in a specific orientation needed for a given surgical plan.
Additionally, with robotic hand-held surgical instruments, the user must counteract the forces or torques generated by the actuating mechanisms in order for the cutting tool to change position. The user may incorrectly counteract the forces and torques by moving or rotating their wrist rather than holding this instrument grasping hand steady. Therefore, the cutting tool may become misaligned or positioned outside of the operable workspace.
Further, robotic hand-held surgical instruments may be bulky and considerably heavy to handle with one hand thereby leading to fatigue and positional error. The user has to maintain a general position and orientation of the device within an operable workspace or along a desired plane to allow the robotic system to create the cuts accurately. The size and weight of the devices may cause the user to drift outside the operable workspace due to muscle strain and fatigue. Operating times and accuracy may suffer as a result.
Thus, there is a need in the art for a wearable brace that can help guide and maintain a hand-held surgical instrument in a position or orientation to execute a surgical plan. There is a further need for a wearable brace that constrains a user's hand or wrist to provide a stiffer object for the hand-held surgical instrument to actuate against. There is an even further need in the art for a wearable brace to alleviate muscle strain and fatigue created by the weight and size of a hand-held surgical instrument.